Coding Validation Specialist (Behavioral Health / Substance Use Disorder)

Location: Remote - US; work from anywhere in the US

Salary: $90,000-$100,000 per year

Company

hirify.global is a healthcare intelligence company providing an AI-powered platform and expertise to health plans to improve payment accuracy, transparency, and efficiency.

What you will do

• Review behavioral health and substance use disorder claims alongside medical records to validate billed procedure and service codes.
• Analyze psychiatric, psychotherapy, SUD, MAT, OTP, IOP, PHP, and ABA coding, documentation, revenue codes, and CPT/HCPCS pairings.
• Identify and resolve coding, reimbursement, compliance, and client-policy issues.
• Develop coding-change rationales affecting APC or EAPG assignments using official coding, billing, Medicare/Medicaid, and ASAM references.
• Document review outcomes while maintaining accuracy, quality, and productivity standards.
• Apply 42 CFR Part 2 confidentiality, MHPAEA considerations, and AHIMA ethical coding standards.

Requirements

• High school diploma or equivalent GED.
• Active, unrestricted RN or LPN/LVN license, or RHIA, RHIT, CPC, or CCS certification.
• At least three years of experience coding or auditing behavioral health and/or SUD claims.
• Knowledge of DSM-5 diagnostic coding as applied to ICD-10-CM and behavioral health/SUD documentation requirements.
• Comprehensive knowledge of APC structures and regulatory requirements for behavioral health and SUD services.
• Strong analytical, critical-thinking, communication, independent-work, and teamwork skills, with comfort using AI-powered search tools and new technologies.

Nice to have

• Associate or bachelor's degree in health information management, nursing, medical coding, or a related field.
• CBHCS or equivalent behavioral health coding credential.
• Experience with post-adjudication, pre-pay, or post-payment claim validation, EAPG claims, MAT, OTP, IOP/PHP documentation, or ABA coding and audits.
• Familiarity with MHPAEA, behavioral health carve-outs, MBHO billing structures, or clinical experience in behavioral health or SUD treatment.

Culture & Benefits

• Digital-first, fully remote work from anywhere in the US.
• Medical, dental, and vision coverage with FSA/HSA options.
• 401(k) with company match.
• Tuition reimbursement and additional health and wellness benefits.
• Flexible and trusting work environment.